In vitro degradation behaviour, cytocompatibility and hemocompatibility of topologically ordered porous iron scaffold prepared using 3D printing and pressureless microwave sintering

Study of the effect of magnetic fields on static degradation of Fe and Fe-12Mn-1.2C in balanced salts modified Hanks' solution

Iron and its alloys are attractive as biodegradable materials because of their low toxicity and suitable mechanical properties; however, they generally have a slow degradation rate. Given that corrosion is an electrochemical phenomenon where an exchange of electrons takes place, the application of magnetic fields from outside the body may accelerate the degradation of a ferrous temporary implant. In the present study, we have investigated the effect of alternating and direct low magnetic field (H = 6.5 kA/m) on the corrosion process of pure iron (Fe) and an iron-manganese alloy (FeMnC) in modified Hanks' solution. A 14-day static immersion test was performed on the materials. The corrosion rate was assessed by mass and cross-sectional loss measurements, scanning electron microscopy, X-ray diffractometry, Fourier-transform infrared spectroscopy and X-ray photoelectron spectroscopy before and after degradation. The results show that the presence of magnetic fields significantly accelerates the degradation rate of both materials, with the corrosion rate being twice as high in the case of Fe and almost three times as high for FeMnC. In addition, a homogenous degradation layer is formed over the entire surface and the chemical composition of the degradation products is the same regardless of the presence of a magnetic field.

Experimental investigation of ultrasonic assisted coating on three-point bending behavior of 3D printed polymeric bone plates for biomedical applications

3D printed Poly Lactic Acid (PLA) bone plates exhibit limited three-point bending strength, restricting their viability in biomedical applications. The application of polydopamine (PDM) enhances the three-point bending strength by undergoing covalent interactions with PLA molecular structure. However, the heavy nature of PDM particles leads to settling at the container base at higher coating solution concentrations. This study investigates the impact of ultrasonic-assisted coating parameters on the three-point bending strength. Utilizing Response Surface Methodology (RSM) for statistical modeling, the study examines the influence of ultrasonic vibration power (UP), coating solution concentration (CC), and submersion time (TIME). RSM optimization recommended 100 % UP, 6 mg/ml CC, and 150 min TIME, resulting in maximum three-point bending strength of 83.295 MPa. Microscopic images from the comparative analysis revealed non-uniform coating deposition with mean thickness of 6.153 µm under normal coating. In contrast, ultrasonic-assisted coating promoted uniform deposition with mean thickness of 18.05 µm. The results demonstrate that ultrasonic-assisted coating induces PDM particle collision, preventing settling at the container base, and enhances three-point bending strength by 7.27 % to 23.24 % compared to the normal coating condition. This study emphasizes on the potential of ultrasonic-assisted coating to overcome the limitations of direct immersion coating technique.

Response surface methodology and machine learning based tensile strength prediction in ultrasonic assisted coating of poly lactic acid bone plates manufactured using fused deposition modeling

Poly Lactic Acid (PLA) based bone plates fabricated using Fused Deposition Modeling have poor mechanical strength which can be improved by biocompatible polydopamine (PDM) coating. However, PDM particles, being heavy in nature, settle at the container bottom with increase in coating solution concentration at the time of bone plate coating using dip coating technique. Thus, the present work aims to witness the effect of ultrasonic assisted coating parameters on tensile strength of coated bone plates. The coating parameters involving power of ultrasonic vibrations, coating solution concentration and immersion time were varied. The standard Response Surface Methodology (RSM) was applied and experimental trials were performed for obtaining tensile strength of bone plates under varied coating parameters. The objective of the present study was to compare the values of tensile strength predicted using RSM and machine learning (ML) models. Based on the obtained experimental values, gradient boosting regression (GBReg), linear regression (LReg) and random forest regression (RFReg) were trained and tested for predicting tensile strength of bone plates. The accuracy and prediction errors corresponding to RSM and ML based models were compared with respect to R2, Mean Squared Error (MSE), Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE). The findings revealed that GBReg exhibited R2, MSE, RMSE and MAE values as 0.9312, 1.7142, 1.2877 and 1.0861 respectively, while RSM showed R2, MSE, RMSE and MAE values as 0.882, 2.13, 1.4595 and 1.258 respectively. RSM model has shown minimum accuracy with high prediction errors amongst the four models. GBReg has outperformed other ML models in terms of their accuracy and error metrics. The present study therefore suggests the application of GBReg based ML model for predicting tensile strength of PDM coated bone plates in response to its accurate and robust prediction performance.

Incorporation of doxorubicin and CoFe2O4 nanoparticles into the cellulose acetate phthalate / polyvinyl alcohol (core)/ polyurethane (shell) nanofibers against A549 human lung cancer during chemotherapy/hyperthermia combined method

Cellulose acetate phthalate (CAP)/polyvinyl alcohol (PVA)/polyurethane (PU) nanofibers were synthesized by simple and coaxial electrospinning (ES) processes. Doxorubicin (DOX) and the CoFe2O4 nanoparticles were loaded into the nanofibers. The performance of the prepared nanofibers was investigated for the sustained release of DOX against A541 lung cancer cells under chemotherapy/external magnetic field (EMF) and alternating magnetic field (AMF, hyperthermia treatment) combined methods in both the in vitro and in vivo conditions. The sustained release of DOX from core-shell nanofibers containing 5 wt% cobalt ferrite was obtained within 300, 600 h, at pH of 5.5 and 7.4 without AMF and 168, 360 h, under an alternating magnetic field (AMF). More than 98.3 ± 0.2 % of A549 cancer cells were killed in the presence of core-shell nanofibers containing 100 μg DOX and 5 % cobalt ferrite nanoparticles in the presence of AMF. The flowcytometric results indicated that only 19.1 and 8.85 % cancer cells remained alive under EMF and AMF, respectively. The in vivo results revealed in stopping the growth of tumor volume and decrease in the relative tumor volume up to 0.5 were obtained using magnetic core-shell nanofibers containing 100 μg DOX and 5 % cobalt ferrite nanoparticles in the presence of EMF and AMF, respectively.

Recent advances in Fe-based bioresorbable stents: Materials design and biosafety

Fe-based materials have received more and more interests in recent years as candidates to fabricate bioresorbable stents due to their appropriate mechanical properties and biocompatibility. However, the low degradation rate of Fe is a serious limitation for such application. To overcome this critical issue, many efforts have been devoted to accelerate the corrosion rate of Fe-based stents, through the structural and surface modification of Fe matrix. As stents are implantable devices, the released corrosion products (Fe2+ ions) in vessels may alter the metabolism, by generating reactive oxygen species (ROS), which might in turn impact the biosafety of Fe-based stents. These considerations emphasize the importance of combining knowledge in both materials and biological science for the development of efficient and safe Fe-based stents, although there are still only limited numbers of reviews regarding this interdisciplinary field. This review aims to provide a concise overview of the main strategies developed so far to design Fe-based stents with accelerated degradation, highlighting the fundamental mechanisms of corrosion and the methods to study them as well as the reported approaches to accelerate the corrosion rates. These approaches will be divided into four main sections, focusing on (i) increased active surface areas, (ii) tailored microstructures, (iii) creation of galvanic reactions (by alloying, ion implantation or surface coating of noble metals) and (iv) decreased local pH induced by degradable surface organic layers. Recent advances in the evaluation of the in vitro biocompatibility of the final materials and ongoing in vivo tests are also provided.

Influence of Dynamic Strain Sweep on the Degradation Behavior of FeMnSi-Ag Shape Memory Alloys

Iron-based SMAs can be used in the medical field for both their shape memory effect (SME) and biodegradability after a specific period, solving complicated chirurgical problems that are partially now addressed with shape-memory polymers or biodegradable polymers. Iron-based materials with (28-32 wt %) Mn and (4-6 wt %) Si with the addition of 1 and 2 wt % Ag were obtained using levitation induction melting equipment. Addition of silver to the FeMnSi alloy was proposed in order to enhance its antiseptic property. Structural and chemical composition analyses of the newly obtained alloys were performed by X-ray diffraction (confirming the presence of ε phase), scanning electron microscopy (SEM) and energy-dispersive spectroscopy. The corrosion resistance was evaluated through immersion tests and electrolyte pH solution variation. Dynamic mechanical solicitations were performed with amplitude sweep performed on the FeMnSi-1Ag and FeMnSi-2Ag samples, including five deformation cycles at 40 °C, with a frequency of 1 Hz, 5 Hz and 20 Hz. These experiments were meant to simulate the usual behavior of some metallic implants subjected to repetitive mechanical loading. Atomic force microscopy was used to analyze the surface roughness before and after the dynamic mechanical analysis test followed by the characterization of the surface profile change by varying dynamic mechanical stress. Differential scanning calorimetry was performed in order to analyze the thermal behavior of the material in the range of -50-+200 °C. X-ray diffraction and Fourier transform infrared spectroscopy (FTIR) along with Neaspec nano-FTIR experiments were performed to identify and confirm the corrosion compounds (oxides, hydroxides or carbonates) formed on the surface.

Comparative Study of Porous Iron Foams for Biodegradable Implants: Structural Analysis and In Vitro Assessment

Biodegradable metal systems are the future of modern implantology. This publication describes the preparation of porous iron-based materials using a simple, affordable replica method on a polymeric template. We obtained two iron-based materials with different pore sizes for potential application in cardiac surgery implants. The materials were compared in terms of their corrosion rate (using immersion and electrochemical methods) and their cytotoxic activity (indirect test on three cell lines: mouse L929 fibroblasts, human aortic smooth muscle cells (HAMSC), and human umbilical vein endothelial cells (HUVEC)). Our research proved that the material being too porous might have a toxic effect on cell lines due to rapid corrosion.

Definition, measurement, and function of pore structure dimensions of bioengineered porous bone tissue materials based on additive manufacturing: A review

Bioengineered porous bone tissue materials based on additive manufacturing technology have gradually become a research hotspot in bone tissue-related bioengineering. Research on structural design, preparation and processing processes, and performance optimization has been carried out for this material, and further industrial translation and clinical applications have been implemented. However, based on previous studies, there is controversy in the academic community about characterizing the pore structure dimensions of porous materials, with problems in the definition logic and measurement method for specific parameters. In addition, there are significant differences in the specific morphological and functional concepts for the pore structure due to differences in defining the dimensional characterization parameters of the pore structure, leading to some conflicts in perceptions and discussions among researchers. To further clarify the definitions, measurements, and dimensional parameters of porous structures in bioengineered bone materials, this literature review analyzes different dimensional characterization parameters of pore structures of porous materials to provide a theoretical basis for unified definitions and the standardized use of parameters.

Compressive Properties and Degradable Behavior of Biodegradable Porous Zinc Fabricated with the Protein Foaming Method

A new protein foaming-consolidation method for preparing porous zinc was developed using three proteins (egg white protein (EWP), bovine bone collagen protein (BBCP), and fish bone collagen protein (FBCP)) as both consolidating and foaming agents. The preparation route utilized powder mixing and sintering processing, which could be divided into three steps: slurry preparation, low-temperature foaming, and high-temperature sintering. The morphological characteristics of the pore structures revealed that the porous zinc had an interconnected open-cell structure. Compared to the porous zinc prepared with EWP or BBCP, the porous zinc prepared with FBCP possessed the largest average pore size and the highest compressive properties. The porosity of the porous zinc increased with the stirring time, the content of protein and sucrose, and higher sintering temperatures. Moreover, a compression test and immersion test were performed to investigate the stress-strain behavior and corrosion properties of the resulting porous zinc. A fluctuated stress plateau could be found due to the brittle fracture of the porous cells. The porous zinc prepared with FBCP showed the highest compressive strength and elastic modulus. The corrosion rate of the porous zinc obtained through an immersion test in vitro using simulated bodily fluids on the thirty-second day was close to 0.02 mm/year. The corresponding corrosion mechanism of porous zinc was also discussed.

Biodegradable Iron and Porous Iron: Mechanical Properties, Degradation Behaviour, Manufacturing Routes and Biomedical Applications

Biodegradable metals have been extensively studied due to their potential use as temporary biomedical devices, on non-load bearing applications. These types of implants are requested to function for the healing period, and should degrade after the tissue heals. A balance between mechanical properties requested at the initial stage of implantation and the degradation rate is required. The use of temporary biodegradable implants avoids a second surgery for the removal of the device, which brings high benefits to the patients and avoids high societal costs. Among the biodegradable metals, iron as a biodegradable metal has increased attention over the last few years, especially with the incorporation of additive manufacturing processes to obtain tailored geometries of porous structures, which give rise to higher corrosion rates. Withal by mimic natural bone hierarchical porosity, the mechanical properties of obtained structures tend to equalize that of human bone. This review article presents some of the most important works in the field of iron and porous iron. Fabrication techniques for porous iron are tackled, including conventional and new methods highlighting the unparalleled opportunities given by additive manufacturing. A comparison among the several methods is taken. The effects of the design and the alloying elements on the mechanical properties are also revised. Iron alloys with antibacterial properties are analyzed, as well as the biodegradation behavior and biocompatibility of iron. Although is necessary for further in vivo research, iron is presenting satisfactory results for upcoming biomedical applications, as orthopaedic temporary scaffolds and coronary stents.

Modifications on porous absorbable Fe-based scaffolds for bone applications: A review from corrosion and biocompatibility viewpoints

Iron (Fe) and Fe-based scaffolds have become a research frontier in absorbable materials which is inherent to their promising mechanical properties including fatigue strength and ductility. Nevertheless, their slow corrosion rate and low biocompatibility have been their major obstacles to be applied in clinical applications. Over the last decade, various modifications on porous Fe-based scaffolds have been performed to ameliorate both properties encompassing surface coating, microstructural alteration via alloying, and advanced topologically order structural design produced by additive manufacturing (AM) techniques. The recent advent of AM produces topologically ordered porous Fe-based structures with an optimized architecture having controllable pore size and strut thickness, intricate internal design, and larger exposed surface area. This undoubtedly opens up new options for controlling Fe corrosion and its structural strengths. However, the in vitro biocompatibility of the AM porous Fe still needs to be addressed considering its higher corrosion rate due to the larger exposed surface area. This review summarizes the latest progress of the modifications on porous Fe-based scaffolds with a specific focus on their responses on the corrosion behavior and biocompatibility.

Biodegradation behaviour of Fe-based alloys in Hanks' Balanced Salt Solutions: Part I. material characterisation and corrosion testing

Research on Fe-based biodegradable alloys for implant applications has increased considerably over the past decade. However, there is limited information on the influence of testing electrolytes on corrosion product formation and general corrosion progress. In this work, the effect of Hanks' Balanced Salt Solution (HBSS) with or without Ca2+ on the corrosion of Fe, Fe35Mn and (Fe35Mn)5Ag powder-processed coupons has been studied using potentiodynamic polarisation, Electrochemical Impedance Spectroscopy (EIS), and preliminary localised measurement of pH and dissolved oxygen concentration in close proximity to the metal surface. Both Fe35Mn and (Fe35Mn)5Ag alloys showed accelerated corrosion when compared to pure Fe based on potentiodynamic testing results, with FeMnAg exhibiting the highest corrosion rate in Ca2+-containing HBSS. The results indicate that in Ca2+-containing HBSS, the formation of a partially protective Ca/P layer decelerates the corrosion progress, whereas the Fe- and Mn-phosphates formed in Ca2+-free HBSS do not have the same effect. The Ca/P layer on (Fe35Mn)5Ag experienced a reduction in resistance following several hours of testing, indicating partial loss of its protective effect.

Insight into the bioabsorption of Fe-based materials and their current developments in bone applications

Iron (Fe) and Fe-based materials have been vigorously explored in orthopedic applications in the past decade mainly owing to their promising mechanical properties including high yield strength, elastic modulus and ductility. Nevertheless, their corrosion products and low corrosion kinetics are the major concerns that need to be improved further despite their appealing mechanical strengths. The current studies on porous Fe-based scaffolds show an improved corrosion rate but the in vitro biocompatibility is still problematic in general. Unlike the Mg implants, the biodegradation and bioabsorption of Fe-based implants are still not well described. This vague issue could implicate the development of Fe-based materials as potential medical implants as they have not reached the clinical trial stage yet. Thus, there is a need to understand in-depth the Fe corrosion behavior and its bioabsorption mechanism to facilitate the material design of Fe-based scaffolds and further improve its biocompatibility. This manuscript provides an important insight into the basic bioabsorption of the multi-ranged Fe-based corrosion products with a review of the latest progress on the corrosion & in vitro biocompatibility of porous Fe-based scaffolds together with the remaining challenges and the perspective on the future direction.

Biodegradable Iron-Based Materials-What Was Done and What More Can Be Done?

Iron, while attracting less attention than magnesium and zinc, is still one of the best candidates for biodegradable metal stents thanks its biocompatibility, great elastic moduli and high strength. Due to the low corrosion rate, and thus slow biodegradation, iron stents have still not been put into use. While these problems have still not been fully resolved, many studies have been published that propose different approaches to the issues. This brief overview report summarises the latest developments in the field of biodegradable iron-based stents and presents some techniques that can accelerate their biocorrosion rate. Basic data related to iron metabolism and its biocompatibility, the mechanism of the corrosion process, as well as a critical look at the rate of degradation of iron-based systems obtained by several different methods are included. All this illustrates as the title says, what was done within the topic of biodegradable iron-based materials and what more can be done.

Local and systemic inflammation after implantation of a novel iron based porous degradable bone replacement material in sheep model

Despite the high potential of healthy bone to regenerate, the reconstruction of large bone defects remains a challenge. Due to the lack of mechanical stability of existing bone substitutes, recently developed degradable metallic alloys are an interesting alternative providing higher load-bearing capabilities. Degradable iron-based alloys therefore might be an attractive innovation. To test the suitability of a newly-designed iron-based alloy for such applications, an animal experiment was performed. Porous iron-based degradable implants with two different densities and a control group were tested. The implants were positioned in the proximal tibia of Merino sheep. Over a period of 6 and 12 months, blood and histological parameters were monitored for signs of inflammation and degradation. In the histological evaluation of the implants` environment we found degraded alloy particles, but no inflammatory reaction. Iron particles were also found within the popliteal lymph nodes on both sides. The serum blood levels of phosphorus, iron and ferritin in the long term groups were elevated. Other parameters did not show any changes. Iron-based degradable porous bone replacement implants showed a good biocompatibility in this experiment. For a clinical application, however, the rate of degradation would have to be significantly increased. Biocompatibility would then have to be re-evaluated.

Extrusion-based 3D printed biodegradable porous iron

Extrusion-based 3D printing followed by debinding and sintering is a powerful approach that allows for the fabrication of porous scaffolds from materials (or material combinations) that are otherwise very challenging to process using other additive manufacturing techniques. Iron is one of the materials that have been recently shown to be amenable to processing using this approach. Indeed, a fully interconnected porous design has the potential of resolving the fundamental issue regarding bulk iron, namely a very low rate of biodegradation. However, no extensive evaluation of the biodegradation behavior and properties of porous iron scaffolds made by extrusion-based 3D printing has been reported. Therefore, the in vitro biodegradation behavior, electrochemical response, evolution of mechanical properties along with biodegradation, and responses of an osteoblastic cell line to the 3D printed iron scaffolds were studied. An ink formulation, as well as matching 3D printing, debinding and sintering conditions, was developed to create iron scaffolds with a porosity of 67%, a pore interconnectivity of 96%, and a strut density of 89% after sintering. X-ray diffracometry confirmed the presence of the α-iron phase in the scaffolds without any residuals from the rest of the ink. Owing to the presence of geometrically designed macropores and random micropores in the struts, the in vitro corrosion rate of the scaffolds was much improved as compared to the bulk counterpart, with 7% mass loss after 28 days. The mechanical properties of the scaffolds remained in the range of those of trabecular bone despite 28 days of in vitro biodegradation. The direct culture of MC3T3-E1 preosteoblasts on the scaffolds led to a substantial reduction in living cell count, caused by a high concentration of iron ions, as revealed by the indirect assays. On the other hand, the ability of the cells to spread and form filopodia indicated the cytocompatibility of the corrosion products. Taken together, this study shows the great potential of extrusion-based 3D printed porous iron to be further developed as a biodegradable bone substituting biomaterial.

In vitro and in vivo evaluation of a nanofiber wound dressing loaded with melatonin

Wound healing is a complicated process that takes a long time to complete. The three-layer nanofiber wound dressing containing melatonin is highly expected to show remarkable wound repair by reducing the wound healing time. In this study, chitosan (Cs)-polycaprolactone (PCL)/ polyvinylalcohol (PVA)-melatonin (MEL)/ chitosan-polycaprolactone three-layer nanofiber wound dressing was prepared by electrospinning for melatonin sustained release. The characteristics of the wound dressing were further evaluated. The wound dressing had a high water uptake after 24 h (401%), and the water contact angle results showed that it had hydrophilicity effect that supported the cell attachment. The wound healing effect of wound dressing was examined using a full-thickness excisional model of rat skin by the local administration of MEL. The gene expressions of transforming growth factor-beta (TGF-β1), alpha-smooth muscle actin (α-SMA), collagen type I (COL1A1), and collagen type III (COL3A1) were further studied. The histopathological evaluation showed the complete regeneration of the epithelial layer, remodeling of wounds, collagen synthesis, and reduction in inflammatory cells. The NF + 20% MEL significantly increased TGF-β1, COL1A1, COL3A1, and α-SMA mRNA expressions. This wound dressing may have a considerable potential as a wound dressing to accelerate the wound healing.

Recent Developments of Biomaterials for Additive Manufacturing of Bone Scaffolds

Recent years have witnessed surging demand for bone repair/regeneration implants due to the increasing number of bone defects caused by trauma, cancer, infection, and arthritis worldwide. In addition to bone autografts and allografts, biomaterial substitutes have been widely used in clinical practice. Personalized implants with precise and personalized control of shape, porosity, composition, surface chemistry, and mechanical properties will greatly facilitate the regeneration of bone tissue and satiate the clinical needs. Additive manufacturing (AM) techniques, also known as 3D printing, are drawing fast growing attention in the fabrication of implants or scaffolding materials due to their capability of manufacturing complex and irregularly shaped scaffolds in repairing bone defects in clinical practice. This review aims to provide a comprehensive overview of recent progress in the development of materials and techniques used in the additive manufacturing of bone scaffolds. In addition, clinical application, pre-clinical trials and future prospects of AM based bone implants are also summarized and discussed.

Additively manufactured biodegradable porous metals

Partially due to the unavailability of ideal bone substitutes, the treatment of large bony defects remains one of the most important challenges of orthopedic surgery. Additively manufactured (AM) biodegradable porous metals that have emerged since 2018 provide unprecedented opportunities for fulfilling the requirements of an ideal bone implant. First, the multi-scale geometry of these implants can be customized to mimic the human bone in terms of both micro-architecture and mechanical properties. Second, a porous structure with interconnected pores possesses a large surface area, which is favorable for the adhesion and proliferation of cells and, thus, bony ingrowth. Finally, the freeform geometrical design of such biomaterials could be exploited to adjust their biodegradation behavior so as to maintain the structural integrity of the implant during the healing process while ensuring that the implant disappears afterwards, paving the way for full bone regeneration. While the AM biodegradable porous metals that have been studied so far have shown many unique properties as compared to their solid counterparts, the unprecedented degree of flexibility in their geometrical design has not yet been fully exploited to optimize their properties and performance. In order to develop the ideal bone implants, it is important to take advantage of the full potential of AM biodegradable porous metals through detailed and systematic study on their biodegradation behavior, mechanical properties, biocompatibility, and bone regeneration performance. This review paper presents the state of the art in AM biodegradable porous metals and is focused on the effects of material type, processing, geometrical design, and post-AM treatments on the mechanical properties, biodegradation behavior, in vitro biocompatibility, and in vivo bone regeneration performance of AM porous Mg, Fe, and Zn as well as their alloys. We also identify a number of knowledge gaps and the challenges encountered in adopting AM biodegradable porous metals for orthopedic applications and suggest some promising areas for future research.